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General NPI Number Information
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NPI Number | 1265887160
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Entity Type | Organization
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Legal Business Name | EYE CARE PROFESSIONALS, LLC
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Dates
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Enumeration Date | 04/28/2016
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Last Update Date | 06/28/2023
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Provider Practice Location Address
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Address Line | 810 W REID AVE STE 1
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City | NORTH PLATTE
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State | NE
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Zip | 69101-6582
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Country | US
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Telephone | 308-221-2020
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Fax | 308-221-6017
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Provider Business Mailing Address
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Address Line | 810 W REID AVE STE 1
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City | NORTH PLATTE
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State | NE
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Zip | 69101-6582
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Country | US
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Telephone | 308-221-2020
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Fax | 308-221-6017
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Authorized Official
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Title or Position | OD/OWNER
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Name | DR. MOLLIE J GOLDEN
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Credential | O.D.
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Telephone | 308-221-2020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 1416
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License Number State | NE
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